Chemotherapy for lung cancer

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The decision to recommend chemotherapy and the choice of drugs depend on the characteristics of the individual patient and the personal experiences and logistic of the oncology clinic.

There are 3 main reasons why chemotherapy is recommended for patients with lung cancer:

• Adjuvant
• Neo-adjuvant
• Palliative/metastatic

The table below lists the most commonly used lung cancer chemotherapy regimen  including  full description of the drugs, how they are given, what to expect and side effects.

Adjuvant chemotherapy

In this situation chemotherapy is given to patients after their lung cancer has been removed with surgery or radiotherapy as an added insurance policy to reduce the chance of it returning in another part of the body  in the future. Some small clinical trials have shown a benefit in these patients but further trials are ongoing to assess exactly how much patients benefit and which patients benefit the most.

Neoadjuvant chemotherapy

In this situation chemotherapy is given before surgery. For lung cancer this is often given in a clinical trial. Outside a trial reserved for situations where the surgeon or oncologist does not feel the tumour could be safely treated with surgery or radiotherapy without shrinking it first.

Palliative chemotherapy

The aim is not to cure, but to control or shrink the tumour especially if it is causing a specific symptom. The aim of this treatment is to improve the quality of life; therefore the side effects from the chemotherapy should not outweigh the benefits of shrinking the tumour.

In these latter two categories, your oncologist would require a full re-assessment of your disease after two or three cycles, to check whether chemotherapy is working effectively. Re-assessment can be a combination of factors. First and foremost the patients symptoms should have improved, secondly the may be a lump or node on examination which should have reduced in size. Thirdly, response could be seen on an X-ray, CT or MRI scan. If the tumour is not responding, the chemotherapy regime could be stopped or changed.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.